Nosebleeds

Nosebleeds (epistaxis) are a common childhood condition, that are usually self-limiting and one that children normally grow out of by around 11 years of age . They are commonly caused by minor injury to the lining of the nose and this can be caused by picking or banging the nose. They can also occur if your child has had a recent cough/runny nose (viral upper respiratory tract infection), if they have allergic rhinitis, blowing the nose too hard, if the inside of the nose becomes too dry or by a foreign body in their nasal passage. Only very rarely can it be due to a bleeding disorder. The bleeding is usually from the front part of the nose and whilst the amount of bleeding may seem like a lot (such as soaking through tissues), it is rare for children to lose so much blood that it causes any problems (such as anaemia). This is only to be likely with frequent, heavy nosebleeds over several weeks or months. 

The advice below should help you decide whether your child’s nosebleed requires further help or whether it can be managed by yourself at home. 

When should I worry and what should I do?

First aid for nose bleeds: 

  • Apply continuous pressure for at least 10 minutes to the fleshy front part of the nose by pinching it between index finger and thumb. Keep the child sitting up and leaning forward, breathing through their mouth (see diagram below). It may be easier to place younger children on your knee facing outwards. Encourage them not to swallow the blood but instead to spit it out, as swallowing blood can cause them to vomit which can then trigger the nose bleeding to restart. 
  • Keep talking to your child with reassurance, and keep them as calm as possible. It is tempting to release the pressure from the nose to check if the bleeding has stopped, but do not do so until the 10 minutes has finished,as this could prevent a clot from forming. If there is an ice pack available, this can be placed on their forehead or on the nape of their neck. 
  • Giving them a cool drink can also help them cool down. 
  • If there is ongoing bleeding after 10 minutes, recheck that the position of the pressure being applied is correct and apply pressure for a further 10 minutes 
  • If at this point, there is ongoing bleeding then you should immediately attend your nearest Accident & Emergency department or call an ambulance and calmly continue applying first aid measures until they arrive. 
  • Click here for first aid advice from the British Red Cross on how to stop a nosebleed in a child. 

 

After the nose bleed: 

If the bleeding has stopped by the first aid measures you have applied, then for the next 24 hours your child should be advised: 

  • Not to pick or blow their nose. 
  • To undertake restful and quiet activities (such as reading or drawing). 
  • To avoid hot baths, showers and warm drinks 
  • To prevent future nose bleeds: 
  • If your child's nose is dry and cracked, apply a petroleum-based jelly (e.g. Vaseline) to the nostrils, generally twice each day for a week. This can be done by using a cotton tip or finger, and gently rubbing it on the inside of the nose. Do not use this method in children under four years of age as they are unlikely to cooperate or sit still, and their nose may be injured. If your child is suffering from constipation, increase their fluid intake and the amount of fibre in their diet, or ask your doctor or pharmacist for a stool softener to prevent them from straining.

Where should you seek help?

  • If it is non-urgent, speak to your local pharmacist or health visitor.
  • Or contact you GP practice and a qualified member of the clinical team will assess if your child needs to be seen urgently.​​​​​​ For an urgent out-of-hours GP appointment, call NHS 111.
  • You should only call 999 or go your nearest A&E department in critical or life threatening situations.

For wear and tear, minor trips and everything in between.

Self-care

You can treat your child's very minor illnesses and injuries at home.

Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.

Sound advice

Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.

For information on common childhood illnesses go to What is wrong with my child?

Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughscolds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.

Sound advice

  1. Visit a pharmacy if your child is ill, but does not need to see a GP.
  2. Remember that if your child's condition gets worse, you should seek further medical advice immediately.
  3. Help your child to understand - watch this video with them about going to the pharmacy.

For information on common childhood illnesses go to What is wrong with my child?

Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.

Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.

Contact them by phoning your Health Visitor Team or local Children’s Centre.

Sound advice

Health visitors also provide advice, support and guidance in caring for your child, including:

  • Breastfeeding, weaning and healthy eating
  • Exercise, hygiene and safety
  • Your child’s growth and development
  • Emotional health and wellbeing, including postnatal depression
  • Safety in the home
  • Stopping smoking
  • Contraception and sexual health
  • Sleep and behaviour management (including temper tantrums!)
  • Toilet training
  • Minor illnesses

For more information watch the video: What does a health visitor do?

School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.

Contacting the School Nurse

Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.

All home educated children will have a named School Nurse.

Sound Advice

Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.

They all have a role in preventing disease and promoting health and wellbeing, by:-

  • encouraging healthier lifestyles
  • offering immunisations
  • giving information, advice and support to children, young people and their families
  • supporting children with complex health needs

Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.

The clinical team in GP surgeries include doctors, advanced nurse practitioners and nurses who are trained to assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP surgery team will arrange a referral to a hospital specialist should you need it.

Sound advice

You have a choice of service:

  1. Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
  2. Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre

For information on common childhood illnesses go to What is wrong with my child?

If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.

Sound advice

Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.

For information on common childhood illnesses go to What is wrong with my child?

A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.

Sound advice

  1. Many visits to A&E and calls to 999 could be resolved by any other NHS services.
  2. If your child's condition is not critical, choose another service to get them the best possible treatment.
  3. Help your child to understand – watch this video with them about going to A&E or riding in an ambulance
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